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VIMED JWEB Manual

Victorian Stroke Telemedicine

Version: 1.0

Created by: Grant Stephens

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1 Table of Contents

1 Table of Contents ............................................................................................................................ 2

2 What is JWEB?................................................................................................................................. 4

3 Accessing JWEB ............................................................................................................................... 4

3.1 For Mac users: Accessing JWEB through VIMED COMM ........................................................ 4

3.1.1 Click on the VIMED COMM icon on your dock................................................................ 4

3.1.2 Click on the VIMED JWEB button near the top of the screen ......................................... 4

3.1.3 Bypass certificate warning(s) (if they appear) by clicking the Continue button(s) ......... 5

3.2 For Windows users: Accessing JWEB through VIMED COMM ................................................ 5

3.2.1 Click on the VIMED COMM icon on either your Desktop or Taskbar ............................. 5

3.2.2 Click on the Web Browser button in the top right corner of the screen ........................ 5

3.2.3 Click on the VIMED JWEB tab near the top of the screen .............................................. 5

3.2.4 Bypass certificate warning(s) (if they appear) by clicking Refresh and Continue ........... 5

4 Logging in ........................................................................................................................................ 6

4.1.1 Click the Login button on the splash page ...................................................................... 6

4.1.2 Enter your JWEB username and password and click the Login button .......................... 6

5 Using JWEB ...................................................................................................................................... 6

5.1 Introducing: The Workspace ................................................................................................... 6

5.1.1 Workspace areas explained ............................................................................................ 7

5.2 Making the Image Window larger .......................................................................................... 7

5.2.1 Using the Separator Bars to resize or hide other areas .................................................. 7

5.2.2 Changing the Database Layout option ............................................................................ 8

5.3 Finding a study ........................................................................................................................ 8

5.3.1 Sort by Study date ........................................................................................................... 8

5.3.2 Arrange list in ascending or descending order ............................................................... 9

5.3.3 Apply a filter (search) ...................................................................................................... 9

5.3.4 Remove a filter .............................................................................................................. 11

5.4 Viewing images ..................................................................................................................... 11

5.4.1 Select a study ................................................................................................................ 11

5.4.2 Select a series ................................................................................................................ 12

5.4.3 Scroll through images in a series .................................................................................. 12

5.4.4 Viewing multiple series simultaneously ........................................................................ 12

5.5 Manipulating images ............................................................................................................. 13

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Show (select) tool. ........................................................................................................................ 14

Grey Values tool. ........................................................................................................................... 14

Contrast tool. ................................................................................................................................ 14

Targeted Contrast tool. ................................................................................................................. 14

Magnifier tool. .............................................................................................................................. 14

Zoom tool. ..................................................................................................................................... 14

Targeted Zoom tool. ..................................................................................................................... 14

Pan tool. ........................................................................................................................................ 14

Rotate tool. ................................................................................................................................... 14

Distance tool. ................................................................................................................................ 14

Rectangular Area tool. .................................................................................................................. 14

Circular Area tool. ......................................................................................................................... 14

Angle tool. ..................................................................................................................................... 15

4-point Angle tool. ........................................................................................................................ 15

Cobb Angle tool. ............................................................................................................................ 15

Polygon tool. ................................................................................................................................. 15

Freehand Line tool. ....................................................................................................................... 15

CTR tool. ........................................................................................................................................ 15

Text Annotation tool. .................................................................................................................... 16

Single Sided Arrow tool. ................................................................................................................ 16

Double Sided Arrow tool. .............................................................................................................. 16

Cine-loop Scroll tool. ..................................................................................................................... 16

Reset Contrast button. .................................................................................................................. 16

Invert Image button. ..................................................................................................................... 16

Display Mode button. ................................................................................................................... 16

Tile Layout buttons. ...................................................................................................................... 16

Fit Image To Window button. ....................................................................................................... 16

Apply Action to All images button. ............................................................................................... 17

Reset All button. ........................................................................................................................... 17

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2 What is JWEB? JWEB is a DICOM PACS solution provided by MEYTEC under the VST program which offers a single

consolidated and centrally managed PACS destination for brain imaging conducted during a VST

consult.

JWEB is hosted at The Florey and is accessed via the internet using a web browser. The most

common method of accessing JWEB is via the VIMED COMM application (this is an application

developed by MEYTEC to combine Videoconferencing, Brain Imaging and access to VST Consult /

Follow Up forms into a single interface).

JWEB negates the requirement to log into site-specific PACS systems, and requires no specialised

software to be installed. Brain images are sent directly from the scanner to the JWEB server and are

accessed using a single username and password.

3 Accessing JWEB The most common method to access JWEB is via the VIMED COMM application. The version of

VIMED COMM for Mac is slightly different to that of Windows but the principle is essentially the

same.

3.1 For Mac users: Accessing JWEB through VIMED COMM

3.1.1 Click on the VIMED COMM icon on your dock

3.1.2 Click on the VIMED JWEB button near the top of the screen

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3.1.3 Bypass certificate warning(s) (if they appear) by clicking the Continue button(s)

You should now be presented with the VIMED JWEB splash page.

3.2 For Windows users: Accessing JWEB through VIMED COMM

3.2.1 Click on the VIMED COMM icon on either your Desktop or Taskbar

3.2.2 Click on the Web Browser button in the top right corner of the screen

3.2.3 Click on the VIMED JWEB tab near the top of the screen

3.2.4 Bypass certificate warning(s) (if they appear) by clicking Refresh and Continue

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4 Logging in To log in to JWEB you must first have navigated to the VIMED JWEB splash page using either the

VIMED COMM application or a separate web browser.

From that point the process of logging in to JWEB is the same for both Mac and Windows users.

4.1.1 Click the Login button on the splash page

4.1.2 Enter your JWEB username and password and click the Login button

You should now be logged in and presented with the JWEB workspace

5 Using JWEB JWEB is not too dissimilar to other image viewers with only subtle differences. It possesses many

standard manipulation features that on the whole are intuitive and easy to use.

5.1 Introducing: The Workspace

When you first log in to JWEB, you are presented with your workspace. How the workspace looks

will differ between instances of JWEB depending on what layout was chosen in the last session.

Workspace layout options are persistent across sessions and independent of users.

By default, the workspace layout will resemble the image below. Each of the main components have

been highlighted for ease of description and will be discussed in greater detail below.

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5.1.1 Workspace areas explained

Colour Name Description

Study Database Pane

Lists the studies in the database. By default, only studies from the last 10 days are shown. Older studies must be searched for

Area Separator Bars

Movable bars that can be dragged to resize areas of the workspace or hide them entirely

Image Window Layout Controls

Controls for subdividing the Image Window so that different series in an image file can be viewed in a synchronised manner

Image File Explorer Pane

A pane containing clickable thumbnail-style representations of each available series in an image file

Image Manipulation Toolbars

These movable toolbars contain controls for image manipulation features and can be docked anywhere in the workspace

Image Window

Clicking on an image series thumbnail in the Explorer Pane will display the first image in that series into this window

5.2 Making the Image Window larger

You can give the Image Window more screen real estate in a number of different ways. The simplest

way to do this is to resize or hide other areas in the workspace.

5.2.1 Using the Separator Bars to resize or hide other areas

You can resize other areas in the workspace by moving the separator bars. To do this:

Hover the mouse pointer over the separator bar until it changes to this picture ( )

Click and drag the bar to its new position then release the mouse button.

Alternatively, you can simply hide other work areas in their entirety by clicking on the Arrow Buttons

located at the leading edge of either bar (see picture below). To un-hide, simply click the opposite

button.

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5.2.2 Changing the Database Layout option

The Database Layout option has three settings:

Setting Effect

Integrate into Image Window (default) The database pane is part of the image window

Auto Flow on Hit The database pane is effectively minimised to a single grey bar at the top of the application window and can be accessed by hovering your mouse cursor over this bar

Show in separate window The database pane is opened in its own separate window that can be minimised and restored like you would any other window on your computer

To access these settings:

Click the settings ( ) icon located on the left hand side of the database pane

From the list that appears, click Database layout

Select a setting that you are comfortable with

Note: The setting is automatically applied when it is selected.

5.3 Finding a study

You can sort and search for studies using the controls in the database window.

Note: Only studies conducted in the last 10 days are displayed – older studies must be searched for

as outlined in this section.

5.3.1 Sort by Study date

Click and drag a column header to the left of the database window to sort the list of studies by the

column’s value. In the example below, the Study date column is used to sort the images by study

date.

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5.3.2 Arrange list in ascending or descending order

A coloured arrow (red or green) to the left of the column header name indicates how the list is

currently arranged. These arrows only appear on the first three columns in the database pane

(regardless of which columns these are).

Click this arrow to toggle between ascending and descending order for that column.

5.3.3 Apply a filter (search)

Applying a filter to a column or columns is effectively how you search for a study.

To apply a filter:

Double-click the column header name of the column you wish to filter by

Type in a search phrase / filter criteria (this can be a word, number or a date)

Press Enter

In the example below, a filter of Institution = “SWAN” is applied. This returns all studies in the

database where the Institution name has the word “SWAN” in it, regardless of its position in the

name.

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Tip: When a filter is applied, the blue sphere icon on the left-hand side of the database pane will turn

red. You can hover the mouse cursor over the icon to reveal what the active filter is.

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5.3.4 Remove a filter

To remove a filter, simply click the red sphere icon on the left-hand side of the database pane.

5.4 Viewing images

5.4.1 Select a study

To view images in a study you must first select a study from the list of studies in the database pane.

To select a study, click once anywhere on the study record (row) as it appears in the database pane.

The study details and image series will appear in the image file explorer pane. By default, no image

series is selected and no image will display until a series is selected.

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5.4.2 Select a series

Scroll through the list of image series in the image file explorer pane and click once on the series you

wish to view.

The series will begin loading and the first image in the series will be displayed in the image window.

While the series is loading, there is a progress bar at the bottom of the image window which will run

left to right indicating the progress of indexing (blue highlighted area below) and loading (green

highlighted area below) the images.

Indexing occurs first and fastest and it needs to complete before you can skip ahead to any image in

the series. Once an image has been indexed, JWEB draws a small vertical white line in the bar. This is

repeated for every image in the series.

Images are then loaded either on demand (if you skip ahead to an image in the series without first

viewing images before it) or recursively in image order starting with image 1. As each image is

loaded, JWEB doubles the height of the white line it drew during the image indexing process. If you

skip ahead to an image in the series, once that image is loaded JWEB recommences recursive loading

of images in reverse from your current point in the series until eventually all images in the series are

loaded.

Note: The time it takes for images in a series to index / load will largely depend on the quality of the

internet connection you have at the time of accessing JWEB and the number of images in the series.

5.4.3 Scroll through images in a series

Once you have selected an image series, click anywhere in the image window and you can then scroll

through the images in the series using the following methods:

Action Effect

Arrow Up / Arrow Left / Mouse-wheel up Scroll forward through images

Arrow Down / Arrow Right / Mouse-wheel Down Scroll backward through images

You can also scroll through the images using the Cine-loop Scroll control on the toolbar. To do this,

click the Cine-loop Scroll button ( ) on the toolbar, then click hold the mouse button down

anywhere in the image window and move the mouse forward and backward whilst holding the

mouse button down. The images will scroll in relation to the direction you move the mouse.

5.4.4 Viewing multiple series simultaneously

Multiple series within the same image file can be synchronously displayed side-by-side in the image

window by using the Image Window Layout Controls which are located just above the Image File

Explorer window.

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Each button represents a pre-defined window layout configuration, with the additional option of

being able to further divide up the image window area by clicking on the ‘plus’ button on the right to

add more windows.

To view two or more series from the same image file side-by-side, first choose an image window

layout by clicking on one of these buttons, then use your mouse to drag and drop each of the

desired series individually into their own windows.

In this mode, the arrow keys will scroll through both image series simultaneously, but if you need to

progress one image series in isolation this can be achieved by clicking on the image window for that

series and using your mouse-wheel or the Cine-Loop Scroll button on the toolbar (as outlined

above).

5.5 Manipulating images

The following is an outline of the commonly used image manipulation features of JWEB.

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Button Feature

a Show (select) tool. Changes the mouse cursor back to normal allowing selection of objects in the image window.

b

Grey Values tool. Changes the mouse cursor to a circle – move the circle to any area of the image then click and hold the left mouse button to display grey values at that point. You can move the mouse around whilst holding the left mouse button to get grey values along the cursor’s path.

c Contrast tool. When this tool is selected, click and drag across the image window to increase / decrease the contrast of the image.

d

Targeted Contrast tool. When this tool is selected, click and drag to form a rectangle over the portion of the image you want to view. When you release the mouse button, JWEB will apply a contrast to the entire image equivalent to the inverse of the mean grey values inside that rectangle.

e

Magnifier tool. When this tool is selected, move the mouse cursor (magnifying glass) to the area of the image you wish to magnify and then click and hold the left mouse button. A magnified view of that point will appear in a small square where the mouse cursor was. You can hold the left button down whilst moving the mouse to magnify the image along the cursor’s path.

f Zoom tool. When this tool is selected, click and drag across the image window to increase / decrease the zoom factor.

g Targeted Zoom tool. When this tool is selected, click and drag for form a rectangle over the portion of the image you want to enlarge. When you release the mouse button, JWEB will enlarge that portion of the image to the largest possible zoom factor.

h Pan tool. When this tool is selected, click and drag from any point in the image window to pan the image in any direction relative to the movement of the mouse.

i

Rotate tool. When this tool is selected, click and drag the mouse on any point outward of the centre of the image window and move the mouse around the central point in the direction you wish to rotate the image. When you release the mouse button, the image will remain where you have rotated it to (until it is reset).

j

Distance tool. Use this tool to measure the distance between two points. When selected, click on the first point then click on the second point. A measurement (in millimetres) will be displayed next to the line that is drawn between the two points. You can repeat this any number of times on the image. Once a measurement line is drawn, you can move it to another area of the image by clicking on the line and dragging it to its new location. You can also move either of the two points to a new position anywhere on the image and the measurement will be re-taken. To delete a measurement line, hover your mouse cursor over the object (it should turn green) and press the Delete key.

k

Rectangular Area tool. Use this tool to measure the area of a rectangular portion of the image which you determine by drawing a rectangle around it. When selected, click on a point on the image which will be the first point of the rectangle. As you move the mouse, the rectangle automatically forms in the direction you move the mouse. Once the resultant rectangle covers your area, click to anchor the second point of the rectangle. Dimensions of the rectangle and its area (in mm2) will be displayed in a text box to the side of the rectangle. You can move the rectangle to any other part of the image by clicking and dragging it by any of its edges. You can also re-size the rectangle by clicking and dragging either of the two points (marked with an X). To delete a rectangle, hover your mouse cursor over the object (it should turn green) and press the Delete key.

l

Circular Area tool. Use this tool to measure the area of a circular portion of the image which you determine by drawing a circle around it. When selected, click on a point on the image which will be the centre of the circle. As you move the mouse, the circle automatically forms outwardly of the central point. Once the resultant circle covers your

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area, click to anchor the outer edge of the circle in place. Dimensions of the circle and its area (in mm2) will be displayed in a text box to the side of the circle. You can move the circle to any other part of the image by clicking and dragging it by its edge. You can also re-size the circle by clicking and dragging either the centre or outer points (marked with an X). To delete a circle, hover your mouse cursor over the object (it should turn green) and press the Delete key.

m

Angle tool. Use this tool to measure angles. When selected, click on a point on the image that is to be the start of the initial side and move the mouse to and click on the point marking the vertex. Now click on a point on the image that is to be the last point of the terminal side. Angle measurement will appear in a text box adjacent to the vertex. Angle arms can be of any length and can be re-adjusted by clicking and dragging either of the points on the initial and terminal side or the vertex itself. You can move the angle drawing by clicking and dragging on one of the angle arms. To delete an angle, hover your mouse cursor over the object (it should turn green) and press the Delete key.

n

4-point Angle tool. Use this tool to measure angles of intersecting lines. When selected, click on a point on the image that is to be the start of the first line and move the mouse to and click on the second point of that line. Now click on a point on the image that is to be the first point of the second line and move the mouse to and click on the second point of that line. Angle measurement will appear in a text box at the end of the first line. Lines can be of any length and do not necessarily have to intersect. Lines can be adjusted by clicking and dragging either of the end points (marked with an X). You can move the entire 4-point angle object by clicking and dragging on one of the lines. To delete a 4-point angle, hover your mouse cursor over the object (it should turn green) and press the Delete key.

o Cobb Angle tool. Use this tool to draw and calculate Cobb Angles. Not used in brain imaging.

p

Polygon tool. Use this tool to draw a polygon surrounding an area on the image. When selected, click on a point on the image which is to be the first vertex of the polygon, then click on each point in the image which is also to be a vertex (except the last point). For the last vertex, double click to place the vertex and close the polygon. Dimensions (including area) of the polygon are displayed in a text box adjacent to the last vertex. You can resize the polygon by clicking and dragging any of the vertices (marked with an X) but you cannot re-open the polygon to add new vertices. You can move the polygon to another area of the image by clicking and dragging one of the sides. To delete a polygon, hover your mouse cursor over the object (it should turn green) and press the Delete key.

q

Freehand Line tool. Use this tool to draw freehand lines anywhere on the image. When selected, click and hold the left mouse button to start drawing, move the mouse to draw and release the mouse button when you have finished. Freehand lines cannot be re-sized, but they can be moved by clicking on them and dragging them to a new location. To delete a freehand line, hover your mouse cursor over the object (it should turn green) and press the Delete key.

r

CTR tool. Use this tool for measuring the ratio (expressed as a percentage) between two areas. When selected, click on a point on the image which represents a corner of the first area and move the mouse cursor to the opposite corner of that area and click the mouse button (for example, click in the top-left corner then in the bottom-right corner). Now repeat this process for the second area. The ratio will be displayed in a text box adjacent to the second point of the second area. Areas can be anywhere on the image and do not necessarily need to be related (for example, second inside the first) although this is a common application for this tool. You can resize area markers by clicking and dragging any of the end points (marked with an X). You can move an area marker by clicking and dragging any of the sides. To delete a CTR object, hover your mouse cursor over the object (it should turn green) and press the Delete key.

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s

Text Annotation tool. Use this tool to add text annotations to an image. When selected, click on a point on the image you wish to annotate and type your text into the box that appears. You do not need to press the Enter key. You can return later to the text box and edit its contents by simply hovering your mouse cursor over the textbox (it should turn green) and begin typing. You can move a text box and its marker (denoted by an X at the top left-hand corner of the textbox) together by clicking and dragging on the marker itself. To separate the textbox from its marker (for example, if you want the marker to appear on the image and the textbox to appear in the black, unused space of the image) simply click and drag the text box itself into a new position. The textbox will ‘refer’ to the marker with a dotted line. Once separated, clicking and dragging either the marker or the textbox will move either one independently of the other. To delete a text annotation, hover your mouse cursor over the object (it should turn green) and press the Delete key.

t

Single Sided Arrow tool. Use this tool to draw an arrow with one head anywhere on the image. When selected, click on a point on the image to which you wish the arrow to point, then move the mouse to where you want the arrow to end and click the mouse. You can resize the arrow or reposition the end-points by clicking and dragging either end-point (marked with an X). You can move an arrow by clicking and dragging the arrow shaft. To delete an arrow, hover your mouse cursor over the object (it should turn green) and press the Delete key.

u

Double Sided Arrow tool. Use this tool to draw an arrow with two heads anywhere on the image. When selected, click on a point on the image to which you want one end of the arrow to point, then move the mouse to where you want the other end of the arrow to point and click the mouse. You can resize the arrow or reposition the end-points by clicking and dragging either end-point (marked with an X). You can move an arrow by clicking and dragging the arrow shaft. To delete an arrow, hover your mouse cursor over the object (it should turn green) and press the Delete key.

v

Cine-loop Scroll tool. Use this tool to scroll through the images in a series using the motion of your mouse. When selected, click and hold the left mouse button down on any point in the image window, and move your mouse up and down whilst holding the mouse button to scroll through the images. Moving your mouse down advances the images, and conversely moving your mouse up scrolls in reverse order toward the beginning of the series.

w Reset Contrast button. Click this button to reset any contrast adjustments you have made to an image.

x Invert Image button. Click this button to invert (create a negative) the image.

y

Display Mode button. Click this button to enable selection between ‘Stack’ (standard)

and ‘Cine’ modes. When in Stack mode, you can select from a number of window layout options using the Tile Layout Buttons. When in Cine mode a set of controls similar to those in a media player appear at the bottom of the image window (see below), allowing for scrolling and playback of images in a series as you would a video file. When you click the play button in whilst in Cine mode, the images automatically scroll one after the other in a forward direction (toward the end) from the position within the series as indicated by the slide at the bottom of the controls. There is another slide to the left which you can use to adjust the rate of advance in frames-per-second. Once Cine mode reaches the final image in a series, it will start again from the first image in the series.

z Tile Layout buttons. When in Stack mode, these buttons provide common layout configurations that you can select by clicking the button which represents the number of windows and layout style you want.

aa Fit Image To Window button. Click this button to expand the image to fit the entire of the Image Window.

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ab Apply Action to All images button. Click this button to apply the next action you carry out to all images in the series. Images in other series will not be affected.

ac Reset All button. Resets zoom, position, rotation and contrast for all image areas.